Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)*
Students entered below will be added to your family's account
How many years have you studied ballet? *
Are you on pointe? If yes, for how many years? *
What other styles of dance have you studied and for how many years? *
Have you performed in a Nutcracker before? If yes, what roles have you held? *
What is your home studio?*
Are you available to rehearse on Saturdays between the hours of 9am and 5pm?*
Are you available to rehearse on Sundays between the hours of 1pm and 7pm? *
Do you have any weekends where you will not be able to rehearse? We will not hold rehearsals on Thanksgiving weekend. *
Additional Information:
Mandatory Rehearsals and Fees
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Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*
eCheck/Bank Draft:
Bank Name:
Bank Routing Number: (9-digit number)
Your Account Name: (Your name on your bank statement)
Your Account Type:   Account Number: